83例原发性鼻腔癌放射治疗的临床疗效分析

Clinical outcome analysis of treating 83 patients with primary nasal carcinoma by radiotherapy

目的通过回顾性分析,寻找鼻腔癌最佳治疗方案和影响预后的因素。方法对83例鼻腔癌单纯外照射治疗进行回顾性分析,放疗方式采用60Co机外照射,以鼻前野为主野,颞颌野为辅野,剂量为40-80Gy,颈部加预防照射。结果83例鼻腔癌中生存10年以上的有30例,生存率为36.1%,死于局部复发21例,死于转移19例。结论鼻腔癌的治疗方案应根据分期,病理类型来选择,以便获得较好疗效。早期病例可行单纯放疗,晚期病例应以综合治疗为主。分化差的鼻腔癌应选择放疗加化疗,而鳞癌,腺癌应以放疗加手术的综合治疗为宜。

Objective To approach the best therapeutic regimen and prognostic indicator for nasal carcinoma by retrospective analysis. Methods To analyze retrospectively 83 patients with nasal carcinoma were treated by radiotherapy. For radiotherapy,γ-ray from 60Co were performed. The anterior irradiation field of nose is major and the temporomandibular irradiation field is minor. Radiotherapeutic dose is from 40Gy to 80 Gy and prophylactic irradiation was performed for neck. Results For the 83 patients with nasal carcinoma ,The 10 year and above survival rate was 36. 1% （30/83）. But 21 and 19 patients died of local recidivation and metastasis respectively. Conclusion To obtain better clinical outcome, the therapeutic regimen for nasal carcinoma should be determined on the basis of staging pathological types. Solitary radiotherapy and combined therapy should be used for early and late nasal carcinoma respectively. Radiotherapy combined with chemotherapy is good for poorly differentiated nasal carcinoma. But for squamouse cell carcinoma and adenocareinoma, radiotherapy and operation is good idea.